As the UK returns to a modicum of normality in light of the ongoing coronavirus pandemic, there are serious concerns over a potential surge in fraudulent personal injury claims. This comes at a time when the UK legal system is creaking, personal injury claims cases are amounting up and insurers are being encouraged to negotiate agreements without going to court.
There are also growing concerns regarding legitimate personal injury claimants who are awaiting much-needed funds having suffered significant physical/mental trauma. The situation is dire enough without taking into account an expected increase in fraud.
Why are insurance companies expecting an increase in fraudulent activity?
Once the UK government pulls the plug on the furlough scheme it is inevitable businesses will go under and jobs will be lost. This will put huge pressure on household finances and unfortunately may tempt some to make fraudulent personal injury claims. In what many see as a “victimless crime” this will likely lead to an increase in prosecutions as fraudsters are held to account.
While it is difficult to say with any great certainty which areas of the personal injury claims market will be targeted, trends will very soon begin to emerge. Some of the more common fraudulent activity in the past has tended to revolve around:-
Injuries in the workplace
Slips, trips, and falls are some of the most common personal injury claims, both within and out of the workplace, and we will likely see an increase in the short to medium-term. The added confusion regarding the coronavirus and additional safety procedures has the potential to muddy what is already a difficult situation. It is therefore advisable that all employers revisit the way in which they operate including issues such as:-
It is fair to say that the regulations regarding the ongoing training of employees have been tightened of late. Even prior to the coronavirus pandemic there were already huge obligations on employers. They are required to carry out regular training sessions and update employees on all aspects of health and safety in the workplace. Whether or not the coronavirus pandemic turns out to be a “one-off” or not is irrelevant, insurance companies and regulators will require even more regular training.
Enhanced health and safety procedures
At this moment in time, the coronavirus is not going away. It is likely to be around in some shape or form for many months if not years to come. There are also concerns about additional contagious outbreaks of similar viruses going forward. Therefore we can expect an emphasis on cleanliness and overall health and safety in the workplace. Unfortunately, for many cash-strapped businesses, this will lead to even greater financial investment.
Signs, instruction manuals, and even new roles in the workplace will become more commonplace in the future. We are also likely to see insurance companies demanding employers do more to protect their employees as a condition of obtaining the relevant insurance cover they require. Whichever way you look at, there is going to be an enhanced cost on employers and this initial period of change and confusion could play into the hands of the fraudsters.
As slowly but surely the UK opens its borders on a reciprocal basis, we will certainly see an increase in holidaymakers leaving for foreign shores. While not outlawed the UK government has not been encouraging of travel overseas. Indeed there are various quarantine regulations already in place for those leaving and those visiting the UK. So, how will holiday companies, hotels, and entertainment providers cover themselves in the event that their customers contract the virus?
At this moment in time it is not possible to sue a UK company/associated partner for directly contracting the virus. However, under current regulations, it is possible to take legal action if that party failed to carry out various health and hygiene tasks or didn’t make customers aware of potential dangers. So it is not the actual contracting of the virus which is central to any future claims but negligence. This could open the door for potential fraudsters and likely lead to a growing number of accommodation/entertainment facilities remaining closed for the foreseeable future.
Use of PPE
As governments around the world continue to recommend the use of various PPE such as masks and gloves in public, this could open up potential issues for hotels, restaurants, and entertainment facilities. The provision of high standard PPE will likely become law, restrictions on social distancing set in stone, and any infringements effectively the responsibility of the proprietor. We have already seen a number of pubs in the UK closing after just a couple of days after confirming positive coronavirus tests. Would cash-strapped businesses be tempted to remain open just a few days longer?
Whether travelling by airline, boat, or any other type of vehicle, getting to and from your holiday destination, and around and about when there, may be a challenge. We have already seen instances of dubious social distancing on some forms of transport which could in theory lead to the proprietor being prosecuted. All businesses, in the UK and overseas, have been warned about the guidance for preventing the spread of the coronavirus. If they choose to open their doors then in effect they are taking on the risk and any potential compensation claims.
Road traffic accidents
Road traffic accidents have been the most common form of personal injury claim for many years in the UK and this is unlikely to change in the foreseeable future. Yes, we have seen a reduction in numbers over the years as regulations tightened but staged events are still not uncommon. In reality, it is more down to the fact some fraudsters have left the road traffic accident scene and moved elsewhere – although many have remained active.
As fraudsters and some members of the general public become ever more desperate we might see an increase in the number of staged accidents. Public services such as bus companies and train companies are only too aware of the challenges and many have introduced CCTV as a means of protecting themselves.
The general public has also taken to the use of dashcams and other recording equipment which can often show staged accidents for what they are, illegal activity. Whether insurance companies going forward will “encourage” the use of dashcams in all vehicles remains to be seen. While the number of staged accidents is nowhere near what they were, they are still a problem for insurance companies.
Such has been the regularity and the cost of fraudulent personal injury claims that the insurance industry has invested literally hundreds of millions of pounds. This has gone into areas such as:-
- Intensive staff training – learning to spot the signs of fraudulent claims
- Lie detection software – can alert concerns regarding caller
- Artificial intelligence searches – spotting trends and connections
In reality, intensive staff training and lie detection software have been in use for some time now whether formally or informally. For many, it is the introduction of artificial intelligence to the mix which holds the greatest potential benefits going forward.
The benefits of artificial intelligence
When you consider that artificial intelligence is by definition a system that is self-learning and continuous, the potential is absolutely huge. The automated analysis of huge sets of data is beneficial in so many ways:-
- Reduced human error
Insurance companies who use artificial intelligence to review current and historic claims have reported a huge reduction in basic errors, otherwise known as human error. While the success of an artificial intelligence system is dependent upon the software, this has the potential to reduce errors to near zero.
- Spotting patterns
The ability to reference, cross-reference, and look backwards and forwards in time, searching through data has led to huge improvements in the ability to spot patterns in fraudulent insurance claims. This may involve something as simple as different branches of the same company, similar surnames, similar addresses, or actual patterns of fraudulent activity.
- Processing time
As we touched on above, modern-day artificial intelligence computers can go through reams and reams of data that it would take humans literally years to go through. So this not only allows them to process ongoing claims but also look back on historic claims to see if any further investigation may be required. Due to the concept of artificial intelligence systems, they will “learn from their mistakes” and continually refine, define, and refine again their processing systems.
Can we expect more prosecutions for fraudulent personal injury claims?
The idea that fraudulent personal injury claims are a “victimless crime” has long been dismantled. Insurance companies had already begun to increase the number prosecuted after lodging fraudulent claims – this will only continue in the short to medium-term. Many prosecutions have seen legal fees and additional costs reclaimed from the fraudsters with a number of them also incarcerated. Slowly but surely the message is getting through to members of the general public looking to commit acts of fraud.
The situation with regard to criminal gangs is a little more complicated because they seem to be continually on the move. While historically they may have been one step ahead of the insurers, the use of artificial intelligence and more focused investment in investigating suspicious claims has put them hot on the heels of the fraudsters.
Unfortunately, as the UK economy gets set for a downturn, an increase in unemployment is inevitable and the risks/potential rewards of fraudulent activity may become a little more palatable to some. It is unlikely that the insurance companies will soften their already toughened approach. So, whether directly involved in fraudulent activity, approached by a third party to make a fraudulent claim or part of a criminal gang, the insurers are after them.